Carotid atherosclerotic plaque is closely related to the occurrence of ischemic stroke and coronary artery disease. Studies have shown that the vulnerability of carotid atherosclerotic plaque is one of the main causes of cardiovascular and cerebrovascular diseases, and its vulnerability is closely associated with the core of lipid necrosis, thin fibrous cap, high levels of macrophages, and intraplaque hemorrhage. With the advantages of easy operation, low cost, high safety and time -saving, ultrasound is more suitable than other imaging methods to become the routine screening method for the vulnerability of carotid atherosclerotic plaque. The article mainly introduces several emerging ultrasound technologies and their convenience and effectiveness, which are expected to detect the vulnerability of carotid atherosclerotic plaques in clinical practice.

Objective To investigate the analgesic efficacy of intrathecal injection of RC-13,a competitive kinesin superfamily protein 17 antagonist,in a mouse model of bone cancer pain.Methods Forty male C3H/HeJ mice,aged 6-8 weeks,weighing 20-25 g,were randomly divided into 5 groups (n=8 each): sham operation group (group S); bone cancer pain + 5 μl dimethyl sulfoxide (DMSO) group (group R0); bone cancer pain + 2.5 μg RC-13 group (group R1); bone cancer pain + 5 μg RC-13 group (group R2) and bone cancer pain + 10 μg RC-13 group (group R3).In groups R0-3,bone cancer pain was induced by implantation of α-min-imal essence medium (α-MEM) containing osteosarcomaNCTC 2472 cells into the intramedullary space of right femur.In group S,culture medium α-MEM containing no cancer cell was injected instead.10％ DMSO 5 μl and RC-13 2.5 μg/5 μl,5μg/5μ1 and 10 μg/5 μ1 dissolved in 10％ DMSO were injected intrathecally in groups R0-3,respectively,once a day for 3 consecutive days starting from 14th day after inoculation of the tumor cells.Pain behavior was assessed by the paw withdrawal mechanical threshold (PWMT) and spontaneous lifting times (SLTs) measured at 1 day before inoculation and at 3,5,7,10,14 days after inoculation.The same tests were also performed at 1,3,5 and 7 days after administration in groups R0-3.Results Compared with group S,PWMT was significantly decreased and SLTs were increased at 7-14 days after inoculation in the other groups (P ＜ 0.05).Compared with group R0,PWMT was significantly increased and SLTs were reduced at 1 day after administration in group R1,at 1and 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R1,PWMT was significantly increased and SLTs were reduced at 3 days after administration in group R2,and at 1,3 and 5 days after administration in group R3 (P ＜ 0.05).Compared with group R2,PWMT was significantly increased and SLTs were reduced at 1 and 3 days after administration in group Rs (P ＜ 0.05).Conclusion Intrathecal RC-13,a competitive kinesin superfamily protein 17 antagonist,has a good analgesic efficacy in a mouse model of bone cancer pain and the efficacy is dose-dependent.

Objective To construct an nomogram model for predicting the risk of ischemic stroke in patients with carotid stenosis,and verify its predictive efficacy. Methods Retrospective collection of 720 patients hospitalized in the First Hospital of Jilin University and Xuanwu Hospital from August 2018 to January 2021.The patients were divided into symptomatic group and asymptomatic group according to their clinical manifestations and imaging examination.The clinical data and carotid ultrasound characteristics were collected,and the risk factors of ischemic stroke in patients with carotid artery stenosis were analyzed by LASSO regression analysis and multivariate Logistic regression analysis.The nomogram model for predicting the risk of ischemic stroke in patients with carotid stenosis was constructed using R4.2.2 "rms" package.Bootstrap method was used to repeatedly sample 1 000 times for internal verification.Consistency index,H-L goodness of fit test and calibration curve were used to evaluate the prediction efficiency of the nomogram model. Results Of 720 patients,295 were classified as symptomatic group,and 425 were classified as asymptomatic group.Multivariate logistic regression analysis showed that hypertension,diabetes,smoking,the degree of carotid stenosis,plaque echogenicity,morphology and thickness were independent risk factors for ischemic stroke in patients with carotid artery stenosis (P<0.05).The nomogram model was constructed based on the above seven risk factors.The ROC curve analysis results showed that the AUC of the nomogram model predicting the risk of ischemic stroke in patients with carotid stenosis was 0.801 (95%CI 0.769-0.833).Bootstrap method was used for internal verification,and the results showed that the consistency index was 0.793.The calibration curve analysis showed that the calibration curve of the nomogram model is close to the ideal curve. Conclusion The nomogram model based on vascular risk factors and carotid ultrasound characteristics in this study has a high degree of differentiation and calibration in predicting the risk of ischemic stroke in patients with carotid stenosis,which is helpful for clinicians to stratify the risk of patients.

Objective:To summarize and compare the characteristics of orthostatic hypotension (OH)　in　patients　with　Parkinson′s disease and multiple system atrophy (MSA).Methods:The active standing test data of 210 Parkinson′s disease patients (Parkinson′s disease group) and 85 MSA patients (MSA group) admitted to the Department of Neurology, Xuanwu Hospital, Capital Medical University from January 2021 to March 2022 were retrospectively analyzed. Demographic information, clinical data, Hoehn-Yahr staging, and Unified Parkinson′s Disease Rating Scale (UPDRS), Non-Motor Symptoms Questionnaire (NMSQ), Montreal Cognitive Assessment Scale and Mini-Mental State Examination scores were collected. The comparative analysis of OH was conducted according to the changes of heart rate and blood pressure during the active standing test.Results:Among the 85 patients with MSA, 52 were found with MSA parkinsonism variant (MSA-P) and 33 with MSA cerebellar variant (MSA-C). The 210 Parkinson′s disease patients were aged (61.5±11.0) years, with 116 males (55.2%). The 85　MSA　patients　were aged (60.1±6.8) years, with 44 males (51.8%). Compared with the Parkinson′s disease group, the Hoehn-Yahr staging [2.0(2.0, 3.0) vs 3.0(2.0, 3.0), Z=-5.278, P<0.001], NMSQ[ 25.0(11.0,46.5) vs 45.0(24.0,70.0), Z=-3.632, P<0.001] and UPDRS scores [50.0(32.0,68.0) vs 65.5(44.5,78.5), Z=-3.073, P=0.003] in the MSA group were higher. The incidence of OH in the MSA group was higher than that in the Parkinson′s disease group [63.5% (54/85) vs 25.7%(54/210), χ 2= 37.284, P<0.001], but there was no statistically significant difference between the MSA-P and MSA-C groups . Compared with the Parkinson′s disease group, the MSA group had a higher incidence of classical OH [54.1%(46/85) vs 12.9%(27/210), χ 2=55.316, P<0.001] and neurogenic OH [36.5%(31/85) vs 9.0%(19/210), χ 2=32.326, P<0.001],but there was no statistically significant difference in the incidence of initial OH and delayed OH between the two groups. The incidence of severe OH in the MSA group was also higher than that in the Parkinson′s disease group [57.6%(49/85) vs 16.7%(35/210), χ 2=49.894, P<0.001], but there was no statistically significant difference in the incidence of pre-clinical OH and mild OH between the two groups. Conclusions:The incidence, time change, severity and pathophysiological basis of OH in Parkinson′s disease and MSA patients are different. Different types of OH may help to distinguish MSA from Parkinson′s disease.